Successful Reconstruction by Omental Graft in a Case of Recurrent Traumatic CSF Rhinorrhea

We reported successful reconstruction by omental graft in a case of reccurent traumatic CSF rhinorrhea. A 21-year-old male was brought to our hospital by traffic accident in coma state. Skull X-ray showed left frontal depressed fracture extending to the superior orbital rim. CT scan revealed traumatic subarachnoid hemorrhage, left cerebral contusional hemorrhage and severe brain swelling, so we carried out removal of the hematoma and external decompression. After that CSF rhinorrhea appeared, but disappeared before long, and after five months he discharged. After one year he returned to our hospital because of meningitis by CSF rhinorrhea. We confirmed the point of leakage from frontal skull base to ethmoid sinus by MRI and metrizamide CT, and we carried out repairment to frontal skull base with temporal muscle and periosteum. After three months he recurred CSF rhinorrhea and this time we carried out reconstruction to frontal skull base used by omental graft separated from abdomen. Since then CSF rhinorrhea has not reccured. Omentum possesses various functions such as protection against infection, ability of various shapes, absorption of CSF and adhesion to the surrounding tissue, so we regards it as very useful material to reconstruction of skull base.